Multi-functional surgical cautery device, system and method of use

ABSTRACT

A surgical cautery device, system, and method of use may apply bipolar and/or sesquipolar electrocautery to target tissue via a pair of instruments with other primary surgical functions. The surgical cautery device and system may include first and second elements capable of forming an electrical circuit. The second element may be independently positionable with respect to the first element. The first and second elements may also include a surgical component with an independent surgical function. Exemplary surgical components include a rotary blade, a cutting tool, a grasper tool, a micro-scissors tool, a micro-grasping forceps tool, a dissector, a micro-dissector, curette, and a suction cannula. On some occasions, one of the surgical components may be interchangeable with another surgical component.

RELATED APPLICATION

This application is a continuation of U.S. application Ser. No.13/922,000, filed Jun. 19, 2013, which claims the benefit of U.S.Provisional Application No. 61/661,459, filed Jun. 19, 2012. Theentireties of the above applications are incorporated by referenceherein and are to be considered part of this specification.

TECHNICAL FIELD

The present invention relates to a surgical device, system, and methodof use and, more particularly, to an endoscopic, minimally-invasive,multi-functional, modular cautery device, system, and method of use.

BACKGROUND

Endoscopic, minimally invasive, surgery relies on instrumentation forachieving hemostasis and surgical outcomes comparable to traditionalopen surgery techniques via comparatively small corridors, or ports,(e.g., nostrils or keyholes) within a patient. As yet, conventionallyused bipolar cautery forceps have not been effectively translated into afunctional instrument for use through the smaller corridors of thisminimally invasive surgery. Presently used bipolar cauterizationinstruments suffer from limited mobility and visualization within thesmaller corridors of minimally-invasive surgery and are difficult to usedue to the relatively poor depth perception and stereoscopic visionoffered within those corridors.

SUMMARY

A surgical cautery device, system, and method of use are hereindescribed. The device is a modified method of applying bipolar and/orsesquipolar electrocautery to target tissue via a pair of instrumentsthat retain other primary surgical functions. The device may include afirst and second element. The second element may be independentlypositionable with respect to the first element. The first and secondelements include a surgical component and may be capable of forming anelectrical circuit. The surgical component may be made from anelectrically conductive material, such as stainless steel. Exemplarysurgical components include a cutting tool, rotary blade, grasper tool,micro-grasping forceps tool, ring curette, dissector or micro-dissector,micro-scissors tool, and a suction cannula, although a wide variety ofinsulated surgical instruments may be incorporated into this system. Thesurgical components are interchangeable, and can therefore be used inany combination to provide cautery application and increase efficiencyof the operation. For example, when one surgical component is a suctioncannula, it may be interchangeable with a cutting tool, a rotary blade,a grasper tool, a micro-scissors tool, a micro-grasping forceps tool, adissector, a micro-dissector, or another suction cannula.

In many instances, the first and second elements are configured tocontact a target tissue of a patient and, upon completion of theelectrical circuit, deliver electrical energy to the target tissue.Often times, the delivery of the electrical energy to the target tissueacts to cauterize the target tissue.

Often times, a tip of the first and second elements may be electricallyconductive while a portion of the first and second elements areelectrically insulated from the tip. The first element and the secondelement may approach the target tissue through, for example, aconventional type of surgical opening, a single port (e.g., anendoscopic or microsurgery port), or a plurality of separate ports inthe patient and may be configured to be manipulated by, for example, bya human surgeon and/or a robot.

Another exemplary device includes an electrically conductive wire thatis electrically connected to an electrically insulated element. Theelectrically insulated element may include an electrically conductivesurgical component. The surgical component may be capable of deliveringelectrical energy to a target tissue of a patient via the electricallyconductive wire.

Exemplary systems consistent with embodiments of the present inventionmay include a source of electrical energy electrically coupled to thefirst and second elements. The second element may be independentlypositionable with respect to the first element. The first and secondelements may have a surgical component and may be capable of forming anelectrical circuit and delivering electrical energy from the source to atarget tissue of a patient upon completion of the electrical circuit.The systems may deliver, for example, cautery, sesquipolar cautery,and/or bipolar cautery.

BRIEF DESCRIPTION OF THE DRAWINGS

The present invention is illustrated by way of example, and notlimitation, in the figures of the accompanying drawings in which:

FIG. 1 depicts an exemplary surgical system, consistent with embodimentsof the present invention;

FIGS. 2A-2D depict exemplary first and/or second elements, consistentwith embodiments of the present invention;

FIG. 2E depicts various exemplary surgical components, consistent withembodiments of the present invention;

FIGS. 3A-3C depict various exemplary sets of surgical components,consistent with embodiments of the present invention; and

FIG. 4 illustrates an exemplary use of first and second elements,consistent with embodiments of the present invention.

WRITTEN DESCRIPTION

Electrosurgical devices apply a high-frequency electric current tobiological target tissue to cut, coagulate, or desiccate the targettissue or at least a portion of the target tissue. Electrosurgicaldevices use a generator (e.g., power supply or waveform generator) and ahand piece including one or several electrodes. Electrosurgerytechniques are used in, for example, dermatological, gynecological,cardiac, plastic, ocular, spine, ear, nose, and throat (ENT),maxillofacial, orthopedic, urological, neuro- and general surgicalprocedures as well as certain dental procedures.

One of the benefits of modem endoscopic surgery is the ability to workthrough two or more ports, via a bimanual and/or robotic approach.Rather than constrain the size and mobility of a cautery device to oneport, one embodiment of the current surgical system proposes a novelelectrocautery technique, in which two separate “electrodes” of thesystem are also independently insulated modular devices with their ownfunctional purpose (e.g., micro-grasping forceps, suction cannula,micro-scissors, dissectors, micro-dissectors, etc.). Thesedually-functioning components of the cautery system can manipulatetarget tissue with much greater mobility and visualization, andindependently transmit opposing current from one electrode to another inorder to achieve a sesquipolar or bipolar cautery effect (depending on,for example, the size and surface area of the conducting electrodesurfaces) from one electrode to the other. Rather than functionallydiverge near the tip of the forceps, as current models for endoscopicbipolar forceps propose, the current invention has two separateelectrodes with dual function as another surgical device. The twoelectrodes diverge outside of the patient rather than within thesurgical cavity, and are connected to each other and a power supply viawiring in order to appropriately transmit opposing high-frequencycurrent to contacted target tissue. Each functional electrode/element ofthe electrocautery device may be insulated with respect to the surgicalcomponent, so that current will only be transmitted selectively from onesurgical component to the other. The modular devices can be connectedand disconnected to, for example, standard wires used with powersupplies, such as bipolar electro cautery generators, and may be used invarious combinations (e.g., suction cannula and micro-scissors ormicro-grasping forceps and micro-scissors). Current may be activated viaany conventionally available means, such as with a foot pedal in amanner similar to existing bipolar devices.

The present invention provides increased mobility and visualization incauterizing the surgical target when compared with conventionaltechniques, by, for example, allowing two or more elements with surgicalcomponents to approach target tissue from different depths, angles,and/or ports. Each surgical component may have independent,interchangeable, and/or functional properties (i.e., cutting, grasping,dissection, sucking, probing, etc.), thus allowing a surgeon tomanipulate delicate surgical target tissue as it is cauterized in anefficient manner. In addition, according to the present invention, thesize of a surgical opening within a patient (i.e., port) need onlyaccommodate one surgical component, which, in many cases, is smallerthan traditionally used cauterizing forceps.

The present invention further allows a surgeon to perform surgicaloperations and cauterize with the same surgical components, therebyreducing the need to remove surgical devices from the patient andsubsequently insert a separate cauterization device. Thus, utilizationof the present invention increases surgical efficiency and potentiallyreduces the risk of infection or damage to surrounding anatomicalstructures that may be caused by repeatedly removing and insertingdevices.

The present invention is more particularly described with regard to theexemplary embodiments depicted in the figures that accompany the instantpatent application. For example, FIG. 1 depicts an exemplary surgicalsystem 100 consistent with some embodiments of the present invention.Surgical system 100 may include a power supply 150, a power cord 155,and an activation device 160. Power supply 150 may be coupled to a firstelement 110 and a second element 120 via an electrical connector 145(e.g., banana clip) electrically coupled to an electrically conductivewire 130. Power supply 150 may be any device capable of supplyingelectrical power, or current, to first and second elements 110 and 120upon user selection of activation device 160. Activation device 160 maybe any conventionally available means for initiating the delivery ofelectricity to first element 110 and/or second element 120 including,but not limited to, a foot petal, a button, or a dial. In someembodiments, an amount of power delivered to first and/or secondelements 110 and 120 may be controlled by manipulation of activationdevice 160 (e.g., twisting a dial) in order to deliver a maximum levelof power, or a fraction thereof, to first and/or second elements 110 and120.

First and second elements 110 and 120 may be configured to deliverelectrical energy 165 from power supply 150 to a contacted, or target,portion of tissue within a patient via surgical components 115 and/125.Exemplary target tissue includes a small blood vessel in need ofcauterization, tumor, or other undesirable tissue to be removed from thepatient. First and second elements 110 and 120 may be configured to bemanipulated by a human surgeon and/or a robot and, on some occasions,may be configured to be used in microscopic or endoscopic single ormultiple port surgery. In some embodiments, a portion of first andsecond elements 110 and 120, with the exception of a first and secondsurgical components 115 and 125, respectively, may be covered inelectrical insulation 135 or may be otherwise insulated. In this way,only surgical components 115 and/or 125 may deliver electrical energyfrom power supply 150 to contacted tissue. Electrical insulation 135 maybe any appropriate electrically insulating material including, but notlimited to, plastic, vinyl, epoxy, parylene, or ceramic and may enable asurgeon to grasp and/or hold first and second elements 110 and 120 via,for example, graspers 140. First and/or second elements 110 and 120 aswell as surgical components 115 and/or 125 may be disposable (i.e., onetime use), or reusable (i.e., capable of being used multiple times).

On some occasions, first and second surgical components 115 and 125 maybe similarly configured to one another with regard to shape and sizeand, in some instances, may comprise a matched pair of components. Onother occasions, first surgical component 115 may be configured toperform a first function in addition to the conduction of electricityand second surgical component 125 may be configured to perform a secondfunction in addition to the conduction of electricity. For example,first surgical component 115 may be configured to be operable by a robotwhile second surgical component 125 may be configured to be operable bya human surgeon. Additionally, one or both surgical components 115and/or 125 may include one or more controls (not shown) that enable amanipulator of the surgical component (e.g., human surgeon or robot) tocontrol the operation of the surgical component.

First and second elements 110 and 120 and/or first and second surgicalcomponents 115 and 125 may configured to be independently positionableby a human surgeon and/or a robot. In this way movement of, for example,first element 110 does not impact the position of second element 120.Likewise, on some occasions, movement of first surgical component 115may not impact the position or functioning of second surgical component125. In this manner, first and second elements 110 and 120 and/or firstand second surgical components 115 and 125 may be moved independentlywithin a patient and/or prior to entry into a patient to, for example,contact target tissue from different angles or enter different portswithin a patient and/or perform different functions (in addition to thedelivery of electricity) within the patient with regard to the targettissue.

In some embodiments, first and second elements 115 and 125 may beinterchangeable with other elements via any known method. For example,first and/or second element 115 and/or 125 may be interchangeable atpower supply 150 via extraction of electrical connector 145 coupled tofirst or second element 115 or 125 from power supply 150 and insertionof another electrical connector compatible with power supply 150 (notshown) electrically coupled to another element (not shown) into powersupply 150. In this way, for example, micro-scissors element 115/125 asdepicted in FIG. 2A (described below) may be interchanged with suctioncannula element 115/125 as depicted in FIG. 2D (described below).Additionally or alternatively, surgical components 115 and/or 125 may beinterchangeable with other surgical components via any conventionallyavailable means, including, but not limited to, unscrewing or otherwisedecoupling surgical component 115 and/or 125 from first and/or secondelements 110 and 120. For example, a surgical component 115 or 125 maybe removed from element 110 or 120, respectively, and another surgicalelement may be attached to the first or second element 110 or 120.

FIGS. 2A-2D depict exemplary first and/or second elements 110/120. InFIG. 2A, first and/or second element 110/120 is configured as amicro-scissors tool, wherein graspers 140 are embodied as scissorhandles, the shaft of the micro-scissors tool is encased in insulation135 and surgical component 115/125 is an electrically conductive set ofmicro-scissors. In FIG. 2B, first and/or second element 110/120 is alsoconfigured as a micro-scissors tool, wherein the entire first and/orsecond element 110/120, with the exception of surgical component115/125, is covered with insulation 135. In FIG. 2C, first and/or secondelement 110/120 is configured as a probe, wherein surgical component115/125 is a surgical probe. In FIG. 2D, first and/or second element110/120 is configured as a suction tool, wherein surgical component115/125 is a suction cannula. FIG. 2E depicts various exemplary surgicalcomponents 115/125, wherein surgical component 115A/125A is a suctioncannula, surgical component 115B/125B is a grasper, surgical component115C/125C is a set of micro-scissors, and surgical component 115D/125Dis a probe.

In some embodiments, first and second surgical components may be similarto, or different from, one another. For example, FIGS. 3A-3C depictvarious exemplary sets of surgical components 115 and 125 as provided byvarious embodiments of the present invention. As depicted in FIG. 3A,first and second surgical components 115B and 125B are configured asgrasping elements that enable a surgeon to grasp and manipulate targettissue as well as cauterize the target tissue. As depicted in FIGS. 3Band 3C, surgical components 115 and 125 are configured differently fromone another. In the embodiment depicted in FIG. 3B, surgical component115A is configured as a suction device and surgical component 115B isconfigured as a grasping component. A surgeon utilizing first and secondelements 110 and 120 of this embodiment would thus be enabled to grasptarget tissue, suck material (e.g., blood, bone, and/or target tissue)from the patient, and cauterize target tissue while, for example,suctioning smoke resulting from cauterization to improve visualization.In the embodiment depicted in FIG. 3C, surgical component 115B isconfigured as a grasping tool and surgical component 115C is configuredas a micro-scissors tool. A surgeon utilizing first and second elements110 and 120 of this embodiment would thus be enabled to grasp, cut, andcauterize target tissue without requiring removal or insertion of anyadditional devices.

FIG. 4 illustrates an exemplary use of first and second elements 110 and120 following insertion into two ports of a patient to contact targettissue 405. In this embodiment, first element 110 is inserted into afirst port within the right nostril of a patient and second element 120is inserted into a second port within the left nostril of the patient.In this way, first and second elements may approach target tissue 405from different angles and may move independently of one another.Following insertion of first and second elements 110 and 120 into thefirst and second ports within the patient, the delivery of electricitymay be initiated via user selection of activation device 160 of powersupply 150 thereby forming an electrical circuit. Following activation,electrical power may be delivered to first and/or second elements 110and/or 120 and, upon contact of surgical components 115 and 125 withtarget tissue, electrical energy 165 may be delivered to the targettissue, thereby cauterizing the target tissue. The same applicationcould be used for multi-port surgery in the abdomen, thorax, or anyother surgical site where one or multiple access ports or corridors areutilized.

Hence, an endoscopic multi-port bipolar cautery device, system, andmethod of use have been herein described.

1-19. (canceled)
 20. A surgical method, comprising: selecting a firstsurgical component and a second surgical component from a systemcomprising a plurality of surgical components each configured to deliverelectrical energy to target tissue, wherein the system comprises atleast two surgical components configured to perform an additionalfunction in addition to delivering electrical energy to target tissue,and wherein the system comprises at least two surgical componentsconfigured to perform different additional functions from each other;delivering the first surgical component to a desired location within apatient; delivering the second surgical component to a desired locationwithin the patient, wherein the second surgical component is positionedindependently of the first surgical component; and delivering electricalenergy to the first and second surgical components to cauterize tissue.21. The method of claim 20, wherein the system comprises at least twosurgical components configured to perform an additional functionselected from the group consisting of grasping, suction, cutting anddissection.
 22. The method of claim 20, wherein the first surgicalcomponent and the second surgical component are selected from a systemcomprising a grasper tool, a suction tool, a cutting tool and adissection tool.
 23. The method of claim 20, wherein the first surgicalcomponent delivered into the patient is used to perform an additionalfunction in addition to delivering electrical energy to target tissue.24. The method of claim 23, wherein the second component is used toperform an additional function different from the additional function ofthe first surgical component.
 25. A surgical method, comprising:delivering a first surgical component to a desired location within apatient, wherein the first surgical component is configured to deliverelectrical energy to target tissue; delivering a second surgicalcomponent to a desired location within the patient, wherein the secondsurgical component is configured to deliver electrical energy to targettissue, and wherein the second surgical component is positionedindependently of the first surgical component; delivering electricalenergy to the first and second surgical components to cauterize tissue;and performing an additional function in addition to the delivery ofelectrical energy to target tissue with at least one of the first andsecond surgical components, wherein the additional function is selectedfrom the group consisting of grasping, suction, cutting and dissection.26. The method of claim 25, wherein at least one of the first and secondsurgical components performs the additional function of grasping tissue.27. The method of claim 25, wherein at least one of the first and secondsurgical components performs the additional function of suction.
 28. Themethod of claim 25, wherein at least one of the first and secondsurgical components performs the additional function of cutting tissue.29. The method of claim 25, wherein at least one of the first and secondsurgical components performs the additional function of dissection. 30.The method of claim 25, comprising performing an additional functionwith both the first and second surgical components.
 31. The method ofclaim 25, wherein the additional function is performed simultaneouslywith delivering electrical energy.
 32. The method of claim 31,comprising delivering electrical energy to the first and second surgicalcomponents to cauterize tissue while simultaneously cutting tissue withat least one of the first and second surgical components.
 33. The methodof claim 31, comprising delivering electrical energy to the first andsecond surgical components to cauterize tissue while simultaneouslygrasping tissue with at least one of the first and second surgicalcomponents.
 34. The method of claim 31, comprising delivering electricalenergy to the first and second surgical components to cauterize tissuewhile simultaneously providing suction with at least one of the firstand second surgical components.
 35. The method of claim 25, wherein thefirst and second surgical components are inserted into the nostrils ofthe patient.
 36. The method of claim 25, wherein the first and secondsurgical components are delivered to a skull base tumor.
 37. The methodof claim 25, wherein the first surgical component and the secondsurgical component are delivered into the patient through a singlesurgical opening.
 38. The method of claim 25, wherein the first surgicalcomponent and the second surgical component are delivered into thepatient through at least one endoscopic or microsurgery port.
 39. Themethod of claim 38, wherein the first surgical component is insertedthrough a first endoscopic or microsurgery port and the second surgicalcomponent is inserted through a second endoscopic or microsurgery port.40. The method of claim 38, wherein the first surgical component and thesecond surgical component are inserted through the same endoscopic ormicrosurgery port.
 41. The method of claim 25, wherein the first andsecond surgical component are manipulated within the patient by a robot.42. A surgical method, comprising: delivering a first surgical componentto a desired location within a patient, wherein the first surgicalcomponent is configured to deliver electrical energy to target tissue;delivering a second surgical component to a desired location within thepatient, wherein the second surgical component is configured to deliverelectrical energy to target tissue, and wherein the second surgicalcomponent is positioned independently of the first surgical component;performing a procedure at the desired location using the first andsecond surgical components; interchanging at least the first surgicalcomponent for a third surgical component, wherein the third surgicalcomponent is configured to deliver electrical energy to target tissue;and performing an additional function other than delivering electricalenergy using the third surgical component.
 43. The method of claim 42,wherein the additional function performed by the third surgicalcomponent is selected from the group consisting of grasping, suction,cutting and dissection.
 44. The method of claim 42, wherein theprocedure comprises delivering electrical energy to the first and secondsurgical components to cauterize tissue.
 45. The method of claim 44,wherein the procedure further comprises performing an additionalfunction in addition to delivering electrical energy with at least oneof the first and second surgical components.
 46. The method of claim 45,wherein the additional function performed by at least one of the firstand second surgical components is selected from the group consisting ofgrasping, suction, cutting and dissection.
 47. The method of claim 42,further comprising delivering electrical energy to the second and thirdsurgical components to cauterize tissue.
 48. The method of claim 42,wherein interchanging at least the first surgical component for a thirdsurgical component comprises extracting an electrical connector of thefirst surgical component from a power supply and coupling the thirdsurgical component to the power supply via a third electrical connector.49. The method of claim 42, wherein interchanging at least the firstsurgical component for a third surgical component comprises removing thefirst surgical component from an element and attaching the thirdsurgical component to the element.